When you first come for treatment, the first step is to arrive at a diagnosis. This involves an exam where we have to find out why you've come for help, are there any other problems whether or not they seem related, a health history, a brief life history so that I know the kinds of stresses and traumas you have had, habits such as diet and alcohol and tobacco, and a physical exam.
In the physical exam, we will examine, if appropriate, where the symptoms are, feel pulses on both wrists (this is an important part of the exam), and perhaps a few other tests to find where qi is blocked or deficient.
There are two goals to the exam: is this a situation in which acupuncture, acupressure, or herbs is likely to be helpful, and two, if so, what kind of treatment will help the most. I will share these findings with you.

Once I have determined where to intervene in your energetic system, we can proceed with treatment. If we are going to use acupuncture, we'll use needles. Acupuncture needles are tiny and don't go in very far. There can be some pain or discomfort, but more often there are unusual sensations that aren't pain. Sometimes there is no sensation at all.
At the first treatment, I often have to do a clearing treatment on the back which involves leaving needles in. However, for most treatment, I insert the needles and remove them as soon as your body responds, typically a second or two. Then I'll leave you for a few minutes to allow your body to absorb the treatment. When I come back to the room, I'll read your pulses again to see how the treatment is working and then decide whether or not more treatment is needed.
People are always nervous at the first treatment, but once they experience five element work, they are fine. Most people get very relaxed on the table and often fall asleep.